Symptoms of a Heartbreak

by Sona Charaipotra

Vish turns beet red.

  “You gonna play college lacrosse?” Arun says. “I could put a good word in at Rutgers.”

  “Dunno yet,” Vish says, scooting away, though there’s nowhere to go. “I’m thinking California, maybe?” He points to the camera. “Hollywood and everything.”

  “I wanted to go to Cali, too. Mom wouldn’t even let me apply.” Taara pouts and shreds the wrapper from her straw. “But Rutgers isn’t so bad.”

  “Actually,” I say, “Rutgers is ranked among the top hundred public universities in the nation, and its affiliation with UMDNJ makes it a very logical move for you, Taa—”

  A sudden crash silences the restaurant noise. Oh no, the cake? Again? But Mom’s not back yet.

  It’s my little cousin Pinky, who’s collapsed onto the dirty linoleum floor. Vomit spills from her little lips, and they’re turning from pale pink to blue. Her eyes roll back in her head.

  I jump up and rush over to her.

  “Pinky!” Anya Auntie shouts, letting out a peal of anguish unlike any sound I’ve ever heard before.

  Pinky’s body flops and goes stiff, then starts flopping again. I drop down next to her, my eyes on my smartwatch, counting. My uncle Ramesh scoops her up, trying to hold her quaking body still.

  “Turn her on her side,” I say.

  He doesn’t hear me, his body frozen with panic.

  “Her side, please. It’s important!”

  Fluid spills out of Pinky’s mouth and onto the floor.

  He nods and does it. The shaking doesn’t stop.

  “Don’t touch her,” Anya Auntie keeps yelling at me. “And someone call 911!” Anya sobs. “Please! My baby!”

  I kneel closer, peering at her to see if she has food in her mouth.

  Nothing.

  “Does Pinky have any allergies?” I ask. I try to remember—nuts, soy, shellfish, but Pinky eats anything, as far as I know. Not that Anya lets us see her all that often.

  He looks at me with a stunned expression.

  “Ramesh Uncle,” I say gently this time, trying to calm him down.

  “No, no, nothing that we know of,” he says, his voice panicked.

  I lean in, undoing the ribbon and zipper on Pinky’s frilly dress, trying to give her as much breathing room as possible.

  Anya Auntie pushes forward again, eager to shove my hands away from Pinky. “The paramedics are coming.”

  “This could be a reaction to nuts or honey,” I say.

  Ramesh Uncle is still frozen in his stupor.

  “Taara, move the tables and chairs away!” I yell out, and she and Lizzie follow orders for once.

  “What’s wrong with her?” Ramesh Uncle asks, anxious.

  “How about low blood sugar levels? Any known history of that?” I ask. “Has she had a high fever? A recent head injury? Has she been around other sick children?”

  He shakes his head.

  “Does she have medication? Prior history of seizures?” I already know the answers. She’s been perfectly healthy—until now.

  Ramesh Uncle shakes his head again.

  “Don’t touch her. Don’t touch her!” Anya Auntie shouts, her voice frantic and full of sobs.

  Sirens wail outside.

  My mother marches back inside and makes eye contact with me, instantly mirroring the worry she sees on my face. She drops the cake and rushes forward, trying to make her way through the crowd. “What’s going on? Saira!”

  The cake box is splayed open and thick white frosting is splattered everywhere. She kneels down beside me, looking from me to Ramesh Uncle, and touches Pinky’s forehead.

  Pinky’s shaking stops, just like that, like when the washing machine is done with its cycle.

  “She’s okay, Mom,” I say. “For now.”

  The paramedics push through.

  “Step back, step back, move!” a female paramedic shouts, parting the crowd, kneeling down next to Pinky. “Miss, I need you to back away,” she tells me.

  I don’t move. She tries to push me away—physically. I catch her hands. “Seems like a seizure, first known incidence, clocking at three minutes before resolving itself,” I say calmly. “Her lips turned blue before going pink again. I’d take her in and do a full workup and—”

  “Step away from her. Now.”

  “I know what I’m doing,” I say.

  “Yes,” Ramesh Uncle says. “She helped my baby. She saved her.”

  “You did the right thing by clearing the space and not moving her, but knowing how to manage a seizure doesn’t make you a medical profess—”

  “I know that. Being a doctor does.”

  She stares blankly at me, her eyebrows drawing together.

  “I am a doctor.”

  She flinches.

  “I’m at Princeton Presbyterian. But you’re right. She should definitely have a formal follow-up, and we can run some tests to see what might have caused this. I’d do a pulse ox, maybe a dose of Diastat to be sure. With no prior history, I’m a bit worried. My mom will know more, but right now Pinky needs medical attention.”

  The paramedic is unimpressed. “Well, we intend to give it to her.”

  I turn to Ramesh Uncle. “The emergency room will run some tests, but she’s awake and alert, which is a good sign. Go with her now. I’ll check in at the hospital tomorrow for an update.” Anya Auntie pushes forward, trying to shove me away again, but I hold firm. “It’s important.” I don’t dare look away from Anya Auntie’s face. I need her to take me seriously, to trust me. “Did you hear me, Anya Auntie? Take her to the hospital. Now.”

  Ramesh Uncle squeezes my shoulder. Pinky’s breathing steadies and she lets out a wail. I take a deep breath, relieved to hear her crying. Anya Auntie leaps forward to hug her baby. Both the paramedic and I pull her back.

  “She needs breathing room right now,” I tell Anya Auntie. “They’ll take her in—you can ride with her. I’ll be there first thing in the morning to check on her.”

  “No, you won’t,” Anya Auntie says. “I want her to see a real doctor.” She looks around the room, hoping to pick another fight with my mother.

  It stings like a slap to the face. My cheeks burn hot as everyone stares. This isn’t the first showdown Anya Auntie and I have had—she’s never quite bought into the Girl Genius thing, and never lets me forget it. But this definitely hurts the worst.

  “Saira is a real doctor,” Taara says. “And either way, Pinky needs medical attention.”

  “We’ll make sure she gets it,” Anya Auntie says, her shoulders squared as she hovers between me and the paramedics, who carefully lay a whimpering Pinky on a gurney and buckle her in.

  “Thank you,” Ramesh Uncle says as they start to follow the paramedics out.

  “I’ll be there—first thing,” I say. “I promise.”

  “And I will, too,” my mom adds.

  Ramesh Uncle nods and races out after the stretcher.

  The din starts up again, slowly at first. Soon, people are talking, laughing, focused on their families and friends. I’m sort of lost in it, standing in the spot where Pinky collapsed, trying to figure out exactly what just happened.

  My dad marches into the room from the bathroom. “What happened?”

  “Oh, nothing!” Lizzie says with a grin. “Just Saira, saving lives and taking names.”

  Papa laughs, murmuring something about cake, but I can’t stop thinking about Pinky. Whatever that was, it wasn’t good.

  * * *

  PRINCETON PAPER—PRINCETON, NJ

  TEEN DOCTOR SAVES TODDLER—AT PIZZA HUT

  The Girl Genius is at it again. Everyone’s favorite real-life Doogie Howser, M.D.—teen doctor and Princeton-native Saira Sehgal—was at it again this weekend. Ralphie Higgins, the manager of the Pizza Hut, reports that the 16-year-old Dr. Sehgal, who recently started as an oncology intern at Princeton Presbyterian, performed emergency care on an unidentified 2-year-old who had a seizure on the premises on Thursday evening.

  “She cleared the
space, checked the child out, and did some medical stuff,” Higgins said. “I can’t even tell you what she did, really. In the end, the girl was A-OK. It was magic to watch—a child saving a child.” The 2-year-old is reported to be in stable condition, though further information about her diagnosis was unavailable.

  Sehgal’s mother, a prominent local pediatrician, runs her own practice affiliated with Princeton Presbyterian, but Higgins says she wasn’t in the room when the incident happened. “The teen was perfectly capable of handling the situation on her own. She’s a real doctor!” Higgins said.

  Stay tuned for more on Dr. Girl Genius—we’re sure she’ll be saving more lives around town.

  CHAPTER 6

  If yesterday felt like the first day of school, today feels like the SATs—when you haven’t cracked a book all summer. Not that I actually know what that would be like. It seems apt, though.

  Today’s our first day of rotations, and I made Mom leave the house super early so we don’t have a repeat of yesterday.

  The oncology floor is bustling, with kitchen staff serving in-patient breakfasts, nurses making their morning rounds, the chemo lab doing the a.m. shift for kids who can still handle going to school.

  I swing open the intern lounge door to meet Arora for rotation, and Cho and Howard are already there. One of the bunks is still sleep-rumpled, so at least one of them spent the night. Show-offs.

  Before I can make my way over to them, a nurse with a stack of folders steps into my path.

  “So you’re her, huh?” the nurse says. He’s tall, with light brown skin and thick, wavy dark hair, and dressed in scrubs. He gives me a proper once-over, all obvious and dramatic, and it would make me cringe if it didn’t make me giggle. He has a stack of files in his hands—for today, I’m presuming—but he doesn’t seem ready to hand them over.

  “Dr. Saira Sehgal, Girl Genius. Have you trademarked that yet, by the way? I read about you in the Star Ledger a couple of years ago. So intriguing. Been following your career ever since,” he says, and a bright, toothy grin plays on his face. “I’m José Gonzalez-Martin, your nurse practitioner extraordinaire. I work frequently with Dr. Arora, so I’ll be on your rotations, as well as Howard’s and Cho’s.” He frowns at this. “That Cho, such a sweetheart.”

  “A peach,” I reply, and put my hand out for the files. I notice the little flag pin that he wears on the collar of his scrubs. “Dominican Republic?” I ask, and point.

  “How dare you?” he says with a mock gasp. “Puerto Rico!”

  I laugh.

  “I wear it so my Spanish-speaking patients know immediately that they can talk to me.”

  “Nice.”

  “Do you still read tarot cards, too?” he asks.

  “That was a really old article,” I say, and he laughs.

  “Yeah, you were, like, twelve then. I guess in teen years that’s, like, decades ago. Maybe we can get a deck to play around with on breaks.”

  “I’ll be honest: They wanted something to ‘soften’ me for the story,” I say, wondering why I’m telling this guy the truth. “My best friend Lizzie is still very much a believer, though. She can read your cards.” I try not to roll my eyes as I say it. Lizzie’s into tarot; Taara’s into astrology. Delusions. Pseudoscience.

  “Well, maybe I’ll manage to convince you. But in the meantime, we’ve got work to do.” He heads toward the computer, and I follow.

  We both sit, and he logs on. “Let me introduce you to your first caseload. You’ll be doing rotations on eight of Abhi’s—that’s Dr. Arora, I mean—patients, along with Dr. Cho and Dr. Howard. You’ll each be assigned specific cases, but for the purposes of training under this special program, you’ll be rotating as a group so you’ll all be up-to-date on everyone.” A wrinkle creases his forehead as he clicks into a screen. “Get ready; this is going to be fun.”

  “Oh, I’ve already been through it—I logged into the online system first thing this morning,” I say as my phone buzzes in my pocket. I ignore it. Lizzie’s finally up, I guess, and harassing me again about the pool party tonight. No thank you. The last thing I want to do with my Friday night is hang out with a bunch of drunk teenagers. “I prefer the neatness of computerized records. I computerized all of my mom’s records when the hospital demanded she be up to code with her electronic medical records system. It was very relaxing.”

  “Sounds like it,” José says. I follow his gaze and realize he’s looking at my hands. I raise an eyebrow, and he grins. “Very nice. Neat, clean, no polish. Dull, but super professional. You don’t want to give them any more reason to distrust you than they already have. These people are putting their kids’ lives into your little hands. I’m glad they’re well manicured. Some of the other interns have got to clean up their act.” He steals a glance at Cho, who’s looking at a stack of files. “Especially their cuticles.”

  I grin at him. He’s definitely got a point. “Have you met my mother yet? She would love you.”

  “Oh, Dr. Sehgal Senior, you mean? Who do you think she brings all those samosas for? I’m her favorite child, not you.” He shuffles through a bunch of papers. “Okay, let’s get to it. So you interns have eight new admits assigned to you. Abhi will supervise your work. One day soon, you’ll each be doing some of those solo, while he and the others observe and offer second opinions.” He leans in close and whispers, “This place is no joke. I’ve seen interns flee the hospital in tears, never to return. I’m rooting for you. I have been since you were twelve.” He glances back at the others again. “Although Cho is fun to look at, when he’s not chewing his fingernails.” Ouch.

  Diagnosis: Charming—and he knows it.

  Prognosis: Future hospital bestie.

  He runs through the protocol—paperwork first, which is mostly complete, our initial visit and confirmation of diagnosis, prognosis, and strategy. All of which I already know. Then plotting out a chart of treatment and procedures.

  “You got this already, but we’re also scheduled with tech for a run-through on the EMR system, too. They’re obsessed with record-keeping here, especially Davis. I presume you won’t have this issue. People have been fired more than once for being sloppy about it.”

  “Yeah, my mom’s told me about the drama with that doctor who got kicked out. She’s glad that I can help her with some of that stuff.”

  “I’d believe it. She keeps saying she wants to recruit you for primary pediatrics—then you can work under her at the hospital and take over her practice.”

  I frown, and he laughs.

  “She didn’t mention that to you? Family practice and all.”

  “She’s mentioned it to me a million times, and I’ve told her a million and one that I’m oncology all the way. Whether she likes it or not.”

  “Oh, you’re in for a mess of trouble with your mama.”

  “I can hold my own.”

  He grins. “I can tell.” He looks at his phone. He stands and claps twice, startling Howard and Cho. “All right, let’s go. You guys are officially on call!”

  Right before we go inside, Arora gathers us for a pep talk. It seems to be his MO, and I actually kind of like it. “So today is a big day. You’ll be introduced to your current caseload, which is mostly new admits. Unlike some residency programs, our approach is more team-based. I’ll observe your interactions the first few weeks, then assign you each specific cases to manage. So while one of you will be assigned as the primary intern on each case, I expect all of you to be informed and up-to-date on each case. Under my supervision, of course.”

  Howard opens her mouth to say something but thinks better of it. Not Cho, though. “Doesn’t that limit our ability to really learn to lead?”

  Arora frowns. He’s clearly proud of his strategy, and didn’t expect questions. “No, quite the opposite. I think it simulates the experience of taking charge and leading while getting active feedback. And sometimes contradictory feedback. I’ve tentatively assigned each of you a patient, so let’s see how it goes thi
s week. Regarding Brendan Jackson: Sam, you’re up.”

  Howard steps in. “Yes, Brendan Jackson, age eight, diagnosed with Stage One non-Hodgkin lymphoma, a type of cancer that develops in the lymph nodes and begins to grow and spread quickly,” she says all formal, as Arora watches and takes notes on her performance. The attending already knows the diagnosis—but we’re graded on our assessments and delivery, like this is a practical exam. “It was discovered as a small swelling on his abdomen and caught pretty early because it was causing him stomach troubles.”

  We walk into the first patient room as a group and are greeted warmly by an older black woman with a shock of graying curls. She’s sitting in a chair, knitting what looks like a blanket in pinks and reds—a clash my mom would surely appreciate.

  “Hello, hello!” she says, standing as we walk in. She marches right up to Howard and shakes her hand, then turns to me and embraces me in a bear hug, even though we’re strangers. “I’m Ruby, Brendan’s grandmother, and this is my daughter Ericka.”

  A younger woman who’s an echo of her mother—the same dark brown skin and hazel eyes—smiles tightly and nods toward me, worry lines marring her otherwise smooth forehead. She’s wearing a suit and her exhaustion like a coat. “Hello,” she says, offering a firm, formal handshake.

  “You must be Saira,” Ms. Ruby says. “Your mama’s told us so much about you, ever since you were knee-high.”

  Before I can speak, Cho shoves himself in the space between the Jacksons and I. “I’m Dr. Cho.” Then he points to José. “And that’s Nurse Gonzalez-Martin. Nice to meet you, Mrs. Jackson.”

  “That’s Ms.,” Ms. Ruby says with a big grin. “I’m quite single. A longtime widow.”

  Cho blushes, and José laughs.

  “Well, Ms. Jackson, let’s get started,” I say, following toward the bed, where a little boy lies.

  “Call me Ruby, dear. And say hello, Brendan.”

  I wave at Brendan, who looks so small in the oversized hospital bed. He’s got bright brown eyes that almost match his skin color and flashes of his grandma’s smile, except a missing tooth or two. He’s got a tablet on his lap and earbuds in, which his grandma pulls out casually. Ericka busies herself rearranging the bedsheets and Brendan’s things.